Common Missteps in Urgent Care Coding and Billing: Misstep #1

Welcome to our blog series on common missteps in urgent care coding and billing. Medical coding and billing is often viewed as its own world, separate from the practice of treating patients. But nothing could be further from the truth. Patient care and billing are intimately connected, and consequently, so is claim reimbursement.

Unfortunately, claims are often plagued by missteps because of the number of steps and people involved in the claim creation process. Reimbursement is the lifeblood of your clinic, so don’t wait for problems to happen. To help you be proactive, we’ve made a series of posts on missteps to avoid. 

Misstep 1: Bad (or No) Payer Contracts 

Before workflow even begins, contracting is where issues can arise. If your clinic has poor or no payer contracts, this will be directly reflected in your clinic’s reimbursement. Only when this is corrected will claims be processed and paid correctly.

Make sure you’re contracted with the payers in your area—preferably prior to opening your urgent care. If you wait to negotiate contracts, your clinic will not be able to accept insurance from patients in your area. While you can accept only cash-pay patients, your patient visits may stay low until more contracts are in place.

Advice: Hire a professional contracting expert who knows payers in your region. They will negotiate on your behalf, understand the fine print details, and know the best contracted rates for your region. Having a versed professional on your side will help you negotiate better rates—especially if you are a new urgent care.

Want to see all the coding and billing missteps we suggest you avoid? Download our free white paper. 

Looking for a better EMR/PM and billing services for your urgent care? Take a look at DocuTAP’s cloud-based, tablet-run EMR and revenue cycle management services designed specifically for urgent care clinics.

This resource was first published prior to the 2019 merger between DocuTAP and Practice Velocity. The content reflects our legacy brands.